The Disease Modifying Effect of Chondroitin Sulphate in Patients With Knee Osteoarthritis has Been Confirmed by MRI

Barcelona (ots/PRNewswire) - A group of Canadian
researchers led by Prof. Jean-Pierre Pelletier, Head of the
Osteoarthritis Research Unit, at the University of Montreal Hospital
Research Centre, published a clinical trial, in which they confirm,
for the first time using quantitative Magnetic Resonance Imaging
(qMRI), the disease modifying effects of chondroitin sulphate, a
symptomatic slow acting drug for osteoarthritis (SYSADOA).

This clinical trial, published in Annals of the Rheumatic
Diseases (impact factor 8.111), explored the effect of chondroitin
sulphate (CS) treatment on cartilage volume loss, subchondral bone
marrow lesions (BML) and synovitis in patients with knee
osteoarthritis (OA). "This study focused on quantifying over time by
MRI the main structural changes observed in the cartilage, bone and
synovial membrane", Prof. Pelletier said.

The investigator states that after only six months of treatment
with CS, patients show a significant decrease in loss of articular
cartilage as compared to the placebo group, and for the first time, a
significant reduction in the progression of BMLs by 12 months.

According to Prof. Pelletier, these data highlight not only the
importance of the interrelationship between cartilage and subchondral
bone in OA, but also its potential role in the disease process and
response to treatment with SYSADOAs.

Prof. Pelletier concluded that, "CS is a safe drug with an
overall positive effect on OA, significantly reducing the volume of
cartilage loss in knee OA, and providing for the first time new
information on its positive effect in vivo on other structural
changes observed in this disease."

Professor Pelletier commented that the clinical trial results
prove that CS is able to slow the progression of OA, however this
does not mean it is able to cure. "The cure involves the regression
of all lesions related to OA, " he says, "and that's not the case.
Chondroitin sulphate slows the progression of the disease. This is an
important finding as a decrease in the rate of progression of
cartilage loss in knee OA patients, as seen by MRI, could potentially
reduce the need for total knee replacement - a phenomenon that has
been observed in other MRI clinical studies."

Confirming Previous Studies

The clinical trial by Prof. Pelletier definitively supports the
findings of previous studies describing the positive effects of CS on
the pathogenic mechanisms of action of OA (Kwan S et al 2007; Monfort
J et al 2005; Bassleer et al 1998; Ronca de 1998, etc), and supports
the ability of CS to modify the natural history of the disease, as
previously demonstrated by Kahan (2009), Michel (2005), and Uebelhart
(1998 and 2004), and the two meta-analyses by Hochberg (2008 and
2010).

Similarly, Prof. Pelletier said that these findings refute the
conclusions reached by S. Wandel et al. in a meta-analysis published
in the British Medical Journal (BMJ) in 2010 to the effect that
SYSADOAs do not offer benefits in the treatment of patients with OA.

In this regard, Prof. Pelletier says, "the methodology used by
Wandel et al. is questionable based on the opinion of several experts
in the field of OA, as reflected by the several letters to the editor
posted on the BMJ website, some of which have also been published in
the official Journal. The results of the Wandel et al. meta-analysis
are in contrast to many other meta-analyses performed by expert
scientists dealing with the same issue, which have shown that CS is
an effective symptomatic treatment for OA and that it can slow
disease progression."

"In line with my previous comments, following the publication of
this meta-analysis, one of the editors from BMJ issued an official
statement in the BMJ website questioning some of the assumptions made
in the article and also mentioning a possible conflict of interest of
the BMJ senior statistics editor, thus seriously questioning the
validity and reliability of this meta-analysis," Prof. Pelletier
specified.

Future goals

The expert says the results of this pilot MRI study are very
positive and encouraging. Given the evidenced efficacy and safety of
the product, it definitely represents a most valuable option for OA
patients. Though he notes, "it is important that patients are
provided with highly purified pharmaceutical grade CS, the one used
in this study, as this is the only one that can guarantee such
efficacy and specially, safety results."

Jean -Pierre Pelletier, MD, Professor of Medicine, Head -
Arthritis Division, Director of Osteoarthritis Research Unit,
University of Montreal Hospital Research Centre (CRCHUM)

(1) Wildi LM, Raynauld JP, Martel-Pelletier J. et al. Chondroitin
sulphate reduces both cartilage volume loss and bone marrow lesions
in knee osteoarthritis patients starting as early as 6 months after
initiation of therapy: a randomised, double-blind, placebo-controlled
pilot study using MRI. Ann Rheum Dis ,March 2011;
10.1136/ard.2010.140848. Epub

ots Originaltext: Prof. Jean-Pierre Pelletier
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